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Symptoms
and Laboratory Findings
Symptoms |
Laboratory Findings
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| •
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Nausea
and vomiting |
•
|
Increased
anion gap
|
| •
|
Abdominal
pain
|
•
|
Increased
lactic acid levels
|
| •
|
Weight
loss
|
| •
|
Malaise |
•
|
Increased
lactate/pyruvate
|
| •
|
Dyspnea/Tachypnea
|
•
Lactic acidosis, a rare and sometimes fatal complication of antiretroviral
therapy, was first reported in the early 1990s. With today’s
use of complex drug regimens, long-term survival, and longer exposure
to drugs, more cases of lactic acidosis are surfacing.1
• Patients who develop lactic acidosis typically complain of
vague, general symptoms over a period of 1 to 6 weeks.2
• Initial gastrointestinal symptoms include nausea, vomiting,
and abdominal pain. Malaise is also present.
• Preceding the lactic acidosis, the patient develops dyspnea
and tachypnea.
• Laboratory findings show increases in anion gap, lactic acid
levels, and lactate/pyruvate.
• It should be re-emphasized that an elevated anion gap is often
present in these patients, although not always. In fact, elevated
anion gap is not a sensitive or a specific way to look for lactic
acidosis in patients suspected of having this syndrome.
References:
1. Cooper DA. Lactic acidosis and hepatic dysfunction associated with
HAART: pathogenesis, clinical manifestations, and predictors. Program
and abstracts of the 7th Conference on Retroviruses and Opportunistic
Infections, San Francisco, CA; Jan 30- Feb 2, 2000. Abstract S21.
2. Boxwell DE, Styrt BA. Lactic acidosis (LA) in patients receiving
nucleoside reverse transcriptase inhibitors (NRTIs). Program and abstracts
of the 39th Interscience Conference on Antimicrobial Agents and Chemotherapy,
San Francisco, CA; Sept 26- 29, 1999. Abstract 1284.
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